Concerned

[nervous1000]

Dr,

I had a possible exposure around 20 days ago, i saw the dr last week and he said it was in the 1 to 600 range and that it was likely medium risk and i would have to be unlucky. Anyway Around 68 hours after exposure i went to the hospital and they put me on PEP (truvada and aluvia) and i did a range tests which all came back negative.

I have been checking every bit of my body for possible symptoms, on day 5 i got a rash, which i think was from the medication, more concerning to me is on day 12 about 1 inch below where my leg meets the torso(ie 1 inch below the crease that goes up from your hip and down to your pubic area) i noticed that that it felt swollen, on both sides it was like 2 bumps, they werent huge but i could run my hand over it and it didnt seem to feel normal and to me felt like a swollen glands, feeling that area didnt seem to feel anything underneath that is suppose to feel like a lymph node. They have been swollen for around a week,  i have had no fever though have started smoking again and got a sore throat for one day. I think today around 8 days later they have started decreasing in size if anything, but they can still be felt.

I am quite concerned that this means that the pep hasnt worked.  There is no reason why i would get swollen glands outside of my scare.  Could PEP give swollen glands, but if so, why only in the groin area.

If it was worst case scenerio(HIV), would the glands be coming down within 7-8 days ? would they be enlarged so quickly(ie 12 days) after possible exposure?

Next week i finish the PEP and the dr said i could come and get tested then after. I have read on the internet that this may give false negatives. i plan on being tested up until 6months after. Is this wise to do straight away?  

[Edward W Hook, MD]

It is correct.  If your glands were swollen becasue of HIV more than just those in your groin would be swollen.  If you doctor is not concerned, you should not be either.  EWH

[nervous1000]

thanks for the speedy reply. i saw the doctor last week and he said they were slighlty swollen, but that it may just be my body. He was quite dismissive given my possible exposure.

It is only my glands in my groin that are swollen, i read somewhere that i would have all over my body swollen glands if i have confirmed exposure, is this true?

[Edward W Hook, MD]

Welcome to the Forum.  Trying to sort out what is drug effect from your PEP and what might be due to other causes is quite difficult.  Swollen glands are certainly not among the drugs commonly used for PEP but with drugs, almost any side effect is possible.  In addition however, I would add that the are virtually an enumerable number of possible causes of swollen lymph glands, if that is what you are feeling at the top of your leg.  The way to address the problem for starters is to see your doctor and first and foremost find out if what you feel are abnormally swollen nodes.  

The only way to know if the PEP worked is with laboratory testing for HIV.  The trials of the true efficacy of PEP are still underway however most people think that it will be highly active. Evaluation of whether or not is worked can be done periodically but the standard recommendation is that the final assessment of whether or not PEP worked should be based on testing at 12 weeks following completion of PEP.

I hope these comments are helpful to you.  EWH